Podcast Summary
Being a little extra can make a difference in health care and comfort: UnitedHealthcare's supplemental insurance plans and Bombas' comfortable clothing help manage costs and improve comfort. Palliative care focuses on alleviating suffering and improving quality of life during health crises.
Being a little extra, especially when it comes to health care and comfort, can make a significant difference. UnitedHealthcare's Health Protector Guard fixed indemnity insurance plans, underwritten by Golden Rule Insurance Company, serve as a supplement to primary plans, helping individuals manage out-of-pocket costs. Meanwhile, Bombas provides comfortable clothing while also donating items to those in need. In the realm of health, palliative care is an essential yet often overlooked topic, especially during times of crisis like the ongoing pandemic. Palliative care focuses on alleviating suffering and improving quality of life, rather than just treating the disease process. Dr. BJ Miller, a palliative care doctor at UCSF Medical Center and author of "A Beginner's Guide to the End," shares his insights on this crucial aspect of care. By embracing the idea of being a little extra, we can make a positive impact on both our own lives and the lives of others.
Easing suffering, not just end-of-life care: Palliative care improves quality of life, extends it, and is not synonymous with giving up on treatment or shortening life.
Palliative care is not just about end-of-life care, but rather, it's about easing suffering, regardless of the stage of a disease. Palliative care and hospice are related but distinct concepts. Palliative care is a team-based approach to managing suffering, while hospice is a subset of palliative care for those approaching the end of life. Contrary to common misconceptions, receiving palliative care does not mean giving up on treatment or shortening one's life. Instead, it can improve quality of life and potentially extend it. The guest shared his personal experience as a triple amputee, which led him to pursue a career in medicine and become a palliative care clinician, emphasizing the importance of addressing suffering and improving overall well-being.
Finding meaning in unexpected circumstances: Embrace your experiences, challenge ableist language, and focus on your interests and values to navigate challenges and find purpose.
Despite facing challenges and adversity, it's possible to find meaning and purpose in unexpected circumstances. The speaker, who is an art history major turned doctor after becoming a triple amputee, shares how he found a way to pay forward the lessons he learned as a patient and turn his situation into an opportunity for service and discovery. He emphasizes the importance of curiosity and embracing one's experiences rather than trying to overcome or hide them. The speaker also highlights the need to challenge ableist language and shift the perspective on disability as a sign of weakness or abnormality. By focusing on his interests and values, the speaker was able to navigate medical school and find a place for himself in the world, inspiring us all to do the same with our own unique experiences.
Personal experiences shape doctors: Empathy gained from personal experiences can help doctors connect with patients, build trust, and provide comfort during end-of-life care.
Having personal experiences, even if they may seem disadvantageous, can be used to connect with patients and make a better doctor. The speaker shared how her experience as a patient helped her empathize with others and build trust faster with her patients. She used this story to apply to medical school and was accepted into UCSF, a place she might not have gotten in without it. In her career in palliative care, she found that people's fears and concerns about death vary, from fear of suffering to leaving loved ones behind. She finds it helpful to acknowledge these emotions and reassure patients that there are ways to manage pain and suffering, often finding that anticipating the experience can be worse than the reality. Ultimately, being present in the moment can bring comfort and peace to patients facing the end of life.
Impact of beliefs on end-of-life experience: Deeply held beliefs provide comfort during end-of-life, while lack or uncertainty can bring distress.
The preparedness and depth of one's beliefs, whether religious or atheistic, significantly impact the experience of facing the end of life. For those with deeply held and examined faiths, the comfort they provide can be a powerful source of peace. Conversely, for those who have not questioned their beliefs or lack thereof, the uncertainty and doubt that can arise at the end of life can be distressing. The discussion also touched upon the topic of physician-assisted suicide, with the speaker sharing their personal experience of losing their older sister to suicide at a young age and the political and legal debates surrounding this issue in California.
Complexities of Mental Health and End of Life Decisions: Intelligence can conceal mental health issues, and death is a complex issue with moral, financial, and personal implications. Some view aid in dying as a compassionate choice for terminally ill patients, while others disagree.
Intelligence can sometimes mask mental health issues, making them harder to diagnose. This was the case with Lisa, who was posthumously diagnosed with bipolar depression despite being highly intelligent and able to manipulate those around her. Another important topic discussed was the concept of death as a choice, with some people desiring it as a release or an end to suffering. The shift in language from "physician-assisted suicide" to "aid in dying" reflects this perspective. Morally, some argue that helping terminally ill patients die is in line with the Hippocratic Oath, while others disagree. The discussion also touched on the financial burden of healthcare and the potential for patients to feel like a burden to their families and society, leading some to consider hastening their death. Overall, the conversation highlighted the complexities surrounding mental health, death, and the role of healthcare in these matters.
Gatekeepers of end-of-life care decisions: Approach decisions with sensitivity, consider underlying causes, integrate palliative care, and offer comfort. Many who seek assisted death never use it.
As healthcare professionals, we hold significant power in end-of-life care decisions, acting as the gatekeepers for patients seeking to hasten their death. However, it's crucial to approach these situations with sensitivity and understanding, as underlying causes may include untreated pain, family pressure, or a cry for help. Palliative care should not be a separate entity but an integral part of everyday discussions with patients. The goal is to offer alternative ways to alleviate suffering and provide comfort, as not all suffering can be treated. Additionally, data from states with assisted death laws show that many people who obtain the medication never use it, highlighting the importance of empowering patients with the knowledge and control that comes with this option.
Integrating Palliative Care into Core Medical Training: Medical professionals should receive foundational palliative care training, enabling them to handle basic needs, while specialists handle complex cases.
Palliative care, which involves providing comfort and support to patients facing serious illnesses or the end of life, should ideally be integrated into the core training of medical professionals, including doctors, nurses, social workers, and chaplains. This approach, known as primary palliative care, would enable most graduates to handle basic palliative care needs without the need for specialists. The ultimate goal is to make palliative care principles foundational, allowing primary care providers to handle the majority of cases, while reserving specialist care for complex cases. Joe, a listener who is not a doctor, asked about current training for doctors in palliative care and the future of this field. The speaker, Dr. Biller, emphasized the importance of listening and compassionate companionship in palliative care, which can help patients find meaning and purpose in their remaining days. He shared an inspiring story of a young patient, Randy Sloan, who embraced love and connection in the face of death. While there is currently elective training for palliative care, the ideal is to make it a core component of medical education.
The Importance of Hospice and Palliative Care in Medical Education and Practice: Hospice and palliative care focus on improving seriously ill or terminally ill patients' quality of life. It's a medical specialty since 2006, but concepts are integrated into various healthcare programs. Prioritize patient experiences and values, challenge current healthcare policies, and encourage open dialogue about death and dying.
There is a growing importance of hospice and palliative care in medical education and practice. This field, which focuses on improving the quality of life for seriously ill or terminally ill patients, has been a medical specialty since 2006. While it may not be the primary focus of all medical training, the concepts of palliative care are increasingly being integrated into various healthcare programs. Another key takeaway is the need for changes in healthcare policy, medical education, and public engagement to prioritize patient experiences and values. The current healthcare system often incentivizes doing more procedures, regardless of their impact on patients. However, there is a push towards a value-based system that prioritizes patient-centered care. Furthermore, the Center for Dying and Living, founded by the speaker, aims to help individuals come to terms with their mortality and start living fully. The organization's website, thecenterfordyingandliving.org, provides resources for navigating the realities of life and death. Overall, the conversation highlights the importance of prioritizing patient experiences and values in healthcare and encouraging open dialogue about death and dying.
The Importance of Accessible and Multidimensional Health Information: Dr. Miller highlights the need for curated health info, patient stories, and open conversations about end-of-life care. Early illness detection in cats with Pretty Litter, and affordable travel essentials from Quinn's. #HealthInfo #EndOfLifeCare #PrettyLitter #Quinns #1800flowers
Accurate and helpful health information is essential for a patient-centric healthcare system. Dr. Miller emphasized the importance of curated, multidimensional information for patients, which can be found at the Center for Dying and Living. However, patients often lack access to such information and need help in learning what they want. To bridge this gap, the Center is starting by harvesting patient and caregiver stories. It's crucial for patients, doctors, and the public to engage in conversations about end-of-life care and for doctors to be more comfortable discussing these topics. You can find more information about the Center on Twitter at @bjmillermd or visit their website at thecenterfordyingandliving.org. Another takeaway is the importance of early detection of illness in cats, which can be achieved with the help of Pretty Litter, a health monitoring litter that changes colors when detecting early signs of illness. Lastly, Quinn's offers high-quality travel essentials at affordable prices, and 1800flowers.com is a one-stop-shop for all your gift-giving needs. Remember, accurate health information, early illness detection, and thoughtful gifts can make a significant difference in people's lives.
